Internists not comfortable caring for childhood cancer survivors

(HealthDay News) -- Many general internists are unfamiliar with care guidelines for childhood cancer survivors (CCSs) and, on average, are somewhat uncomfortable caring for these patients, according to a study published in the Jan. 7 issue of the Annals of Internal Medicine.

Noting that adult CCSs are at high risk for illness and premature death, Eugene Suh, M.D., from the University of Chicago Medicine Comer Children's Hospital and University of Chicago, and colleagues conducted a cross-sectional survey among 1,110 U.S. general internists. The authors sought to determine the doctors' self-reported attitudes and knowledge about CCS care. Care preferences, comfort levels with caring for CCSs, and concordance with Children's Oncology Group Long-Term Follow-Up Guidelines were assessed in response to a clinical vignette.

The researchers found that about half of internists (51.1 percent) reported caring for one or more CCS, and most of these internists (72 percent) did not receive a treatment summary. Internists were "somewhat uncomfortable" caring for Hodgkin's lymphoma, acute lymphoblastic leukemia, and osteosarcoma survivors, on average. In addition, internists reported being "somewhat unfamiliar" with surveillance guidelines. In a clinical vignette about a young survivor of Hodgkin's lymphoma, 90.6, 85.1, and 23.6 percent of respondents did not appropriately recommend breast cancer, cardiac, and thyroid surveillance, respectively. The most useful resources for caring for CCSs were access to surveillance guidelines and treatment summaries.

"Although most general internists are willing to care for CCSs, many seem unfamiliar with available surveillance guidelines and would prefer to follow patients in collaboration with a cancer center," the authors write.